儿科急诊心电监护仪报警管理的循证实践  

Evidence-based practice in the management of ECG monitor alarms in the pediatric emergency department

作　　者：乔姗姗 时璇 春晓 马文成 邓永芳 林艳 QIAO Shanshan;SHI Xuan;CHUN Xiao;MA Wencheng;DENG Yongfang;LIN Yan(Department of Pediatric Emergency,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou,510623,China)

机构地区：[1]广州医科大学附属妇女儿童医疗中心儿科急诊,广州市510623 [2]广州医科大学附属妇女儿童医疗中心内科部,广州市510623 [3]广州医科大学附属妇女儿童医疗中心产科,广州市510623 [4]广州医科大学附属妇女儿童医疗中心护理部,广州市510623

出　　处：《中国护理管理》2025年第2期248-254,共7页Chinese Nursing Management

基　　金：广东省医学科学技术研究基金项目(A2022064);广州市科技计划项目市校(院)联合资助项目(202201020626)。

摘　　要：目的:根据心电监护仪报警管理的证据开展循证实践并评价其应用效果,为提升报警管理效果提供参考。方法:以基于证据的持续质量改进模式为理论框架,于2023年3月—12月,按照证据获取、现状审查、证据引入和效果评价流程将循证实践应用于广州市某三级甲等专科医院儿科急诊,比较循证实践前后心电监护仪报警发生状况、护士报警疲劳水平、护士报警应答时间及审查指标执行率的差异。结果:最终纳入15条证据并转化为15条审查指标。在进行循证实践后,心电监护仪错误报警发生率从75.99%降至44.27%;护士报警疲劳得分从(20.97±5.22)分降至(16.67±8.28)分(P<0.05);护士心电监护仪报警应答时间从(396.95±109.06)s缩短至(352.18±124.84)s(P<0.01)。15条审查指标中,14条审查指标的执行情况明显改善。结论:将心电监护仪报警管理的证据应用于临床护理实践,有助于减少无效报警的发生、缓解护士报警疲劳状况并提高报警管理水平。Objective:To implement evidence-based practice and evaluate its effectiveness based on the evidence of alarm management of ECG monitor,so as to provide reference for improving alarm management strategies.Methods:Using the continuous quality improvement model of evidence as a theoretical framework,evidence-based practice was applied to the pediatric emergency department of a tertiary grade A specialized hospital in Guangzhou from March to December 2023 according to the process of evidence acquisition,current status review,evidence introduction,and effect evaluation.The differences of ECG monitor alarms occurrence,nurses'alarm fatigue level,nurses'alarm response time,and review indicators implementation rate before and after the evidence-based practice were compared.Results:Fifteen pieces of evidence were ultimately included and translated into 15 review indicators.After evidence-based practice,the incidence of ECG monitor false alarms decreased from 75.99%to 44.27%.Nurses'alarm fatigue scores decreased from 20.97±5.22 to 16.67±8.28(P<0.05).Nurses'response time to ECG monitor alarm was shortened from(396.95±109.06)seconds to(352.18±124.84)seconds(P<0.01).Among the 15 review indicators,the implementation rate of 14 review indicators had improved.Conclusion:Applying the evidence of ECG monitor alarm management to clinical nursing practice can help reduce the incidence of invalid alarms,alleviate nurses'alarm fatigue,and improve alarm management.

关 键 词：心电监护仪报警 持续质量改进 循证实践 儿科急诊护理 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]